Provider Demographics
NPI:1538114293
Name:ANIL MOHIN MD, INC.
Entity Type:Organization
Organization Name:ANIL MOHIN MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-659-9572
Mailing Address - Street 1:8641 WILSHIRE BLVD.
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2919
Mailing Address - Country:US
Mailing Address - Phone:310-659-9572
Mailing Address - Fax:310-659-4740
Practice Address - Street 1:8641 WILSHIRE BLVD.
Practice Address - Street 2:SUITE # 100
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2919
Practice Address - Country:US
Practice Address - Phone:310-659-9572
Practice Address - Fax:310-659-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A405060Medicaid
CAF02715Medicare UPIN